title: Microsurgical reconstruction of the mandible in a patient with evans syndrome: a case report and review of the literature.
abstract: In this report, we describe the first successful case of microvascular free tissue transfer in a patient with Evans Syndrome (ES), a rare form of idiopathic thrombocytopenic purpura (ITP) and associated autoimmune hemolytic anemia (AIHA). Microvascular surgery in the setting of ES is likely to have higher complication rates because of the increased risk of postoperative bleeding and free flap thrombosis. The case presented here opens up to the feasibility of microvascular reconstruction of patients with coagulation disorders like ES. Every effort should be made to control for hemolytic, thrombocytopenic, and thrombophilic states associated with ES. In the absence of evidence-based treatment guidelines for ES, personalized treatment protocols with high-dose corticosteroids, immunoglobulin, and postoperative anticoagulation regimen are highly recommended.
authors.affiliation: Unit of Oral and Maxillofacial Surgery, Department of Surgery, Azienda Ospedaliera Universitaria Integrata Verona, Verona, Italy.
authors.forename: Alberto
authors.initials: A
authors.lastname: Bedogni
authors.forename: Alexandre
authors.initials: A
authors.lastname: Anesi
authors.forename: Andrea
authors.initials: A
authors.lastname: Fior
authors.forename: Giordana
authors.initials: G
authors.lastname: Bettini
authors.forename: Pier Francesco
authors.initials: PF
authors.lastname: Nocini
mesh_terms: D000293:Adolescent; D000305:Adrenal Cortex Hormones / Q000627:therapeutic use; D000744:Anemia, Hemolytic, Autoimmune / Q000000981:diagnostic imaging / Q000188:drug therapy / Q000473:pathology / Q000601:surgery*; D005260:Female; D006801:Humans; D063175:Mandibular Reconstruction / Q000379:methods*; D008866:Microsurgery / Q000379:methods*; D016038:Skin Transplantation; D013921:Thrombocytopenia / Q000000981:diagnostic imaging / Q000188:drug therapy / Q000473:pathology / Q000601:surgery*; D014057:Tomography, X-Ray Computed
chemical_list: D000305:Adrenal Cortex Hormones